Healing the injured brain with music : effects on cognitive functions and neural plasticity after a traumatic brain injury

Abstract

Traumatic brain injury (TBI) can cause chronic deficits in cognitive functions, especially executive functions, which can impair the individual's quality of life significantly. At the brain level, TBI is characterized by abnormal functional connectivity patterns of central resting state networks and damage to critical white matter tracts. These are suggested to provoke TBI-related cognitive impairments, which can potentially be ameliorated with rehabilitation. Music-based rehabilitation, such as music therapy interventions, is a potential tool for improving cognitive functions after a brain injury, yet research considering its neural basis is scarce. Thus, this systematic literature review aimed to investigate the effects of music-based interventions on cognitive functions after a TBI and the extent to which this can be seen at the brain level. A literature search was conducted in January 2025 using Scopus and PubMed databases. Relevant articles included experimental trials investigating the effects of music interventions on the cognitive functioning of TBI patients and related neuroplasticity. Eleven articles were included in the review. The results indicate that music interventions may be beneficial for improving executive functions, especially cognitive flexibility and set-shifting after a TBI. Limited evidence was found for short- and long-term memory and attention. At the brain level, increased white matter connectivity in the right dorsal pathways, right thalamic radiation and corticostriatal tract, and de-creased resting-state connectivity between the default mode network and sensory networks and within the frontoparietal network, as well as increased grey matter volume of the right IFG were associated with improved executive functioning. The results imply that improvement of execu-tive functions after a music-based intervention post-TBI may be based on the neural plasticity of central brain networks involved in higher-order cognitive functions. Thus, music therapy may help to restore normal brain functioning and cognitive functions after a brain injury. Future stud-ies with more controlled designs are needed.